PayPredict Today: 2026 Medicare PFS · RVU26D
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2-Limb EMG 5+ musc with 13+ NCS

Billed together on one claim

95913 95886 ×2

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Price for scenario

San Jose Inpatient MD $0.00
Facility · Traditional Medicare
San Jose Outpatient MD $655.75
Office · Traditional Medicare
+ Scenario

San Jose Outpatient MD

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Fee schedule
2026 Medicare PFS · RVU26D
Effective October 1, 2026 · CF $33.4009
Locality
San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09)
Setting · provider
Office (non-facility) rates · Physician
Payer
Traditional Medicare
Priced as of
November 13, 2026
Medicare allowed
$655.75
Total the claim is paid on
Medicare pays
$514.11
80%, less 2% sequestration
Patient owes
$131.15
20% coinsurance, once the Part B deductible is met
Billing rules changed it by
—
from $655.75 at full fee schedule

Nothing to resolve before billing: no prior authorization, documentation or coding flags for these codes.

Claim lines

Highest-paid first, the order Medicare ranks multiple procedures
  1. 95913 $388.45
    Nrv cndj test 13/> studies
    NCS/EMG: real-time testing, tabular data
    Fee schedule $388.45
  2. 95886 ×2 $267.30
    Musc test done w/n test comp
    NCS/EMG: real-time testing, tabular data
    Fee schedule $133.65 × 2 = $267.30
  3. Total allowed $655.75
    $655.75 fee schedule — billing rules

Payment risks · 1

  • NCS/EMG: real-time testing, tabular data 9591395886

    The MAC NCS/EMG LCDs expect a qualified, trained examiner and real-time waveform testing; handheld or delayed-interpretation devices are not separately payable. The record must show the reason for referral and a diagnostic impression, and NCS values (latency, amplitude, velocity) should be kept, preferably in a table. Each NCS code is payable once per nerve. Source

Notes · 1

  • Before the Part B deductible

    Until the patient meets the annual Part B deductible, they pay the full allowed amount instead of 20% coinsurance.

How each fee is calculated (Work RVU × GPCI + PE RVU × GPCI + MP RVU × GPCI) × conversion factor ▸
Code Work Practice expense Malpractice Adjusted RVU × CF Fee Global Multiple procedure Bilateral (50) Assistant Co-surgeon (62)
95913 3.47 × 1.11 5.35 × 1.442
non-facility
 0.16 × 0.397 11.6299 33.4009 $388.45 No global period No reduction No bilateral adjustment Needs documentation Not permitted
95886 0.84 × 1.11 2.12 × 1.442
non-facility
 0.03 × 0.397 4.0014 33.4009 $133.65 Add-on code No reduction 100% each side Needs documentation Not permitted

GPCIs for San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09) in RVU26D. Imaging fees are capped at the OPPS amount when that's lower.